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Billing Resolution Specialist

Wellcare - Tampa, FL

Billing Resolution Specialist','1800926','!*!About WellCare: WellCare Health Plans, Inc. is a Fortune 500 company traded on the New York Stock Exchange (symbol: WCG). It provides managed care services targeted to government-sponsored health care programs, including Medicaid, Medicare, Prescription Drug Plans and the Health Insurance Marketplace. Headquartered in Tampa, Fla., WellCare offers a variety of health plans for families, children, and the aged, blind and disabled. The company serves approximately 4 million members and employs approximately 6,500 people nationwide as of Sept. 30, 2014. For more information about WellCare, please visit our website at or view our videos at All qualified applicants shall receive consideration for employment without regard to race, color, religion, sex, age forty (40) and over, disability, veteran status, or national origin.','!*!

LOCATION:  W. Idlewild Avenue, Tampa, FL 33634

DEPARTMENT:  Operations – Enrollment & Billing  

REPORTING TO:  Supervisor, Operations


Individual will be part of a team that is responsible for researching and resolving escalated member issues that have not been resolved through the normal customer service channels.   Position will require strong attention to detail, interpersonal skills, and patience in dealing with complex member issues.  Daily activities may require creation of detailed member reconciliations and direct explanation to member(s) via telephone contact.  Occasionally may be required to participate in special projects related to improving member experience.

Essential Functions:

Researches incoming member calls or correspondence and logs into database, reconciles, resolves, and ensures communication with member for all assigned billing and cash related inquiries.  Will escalate any issues to supervisor/SR BRS if resolution is not clear or outside step actions defined by supervisor.

Complies with all federal, state, and WellCare Corporate guidelines performing such duties in a professional and courteous manner to avoid member abrasion while meeting and exceeding all minimum performance and quality assurance standards.

Thoroughly researches complex issues and takes appropriate action to resolve them within established service level agreements adhering to quality call back standards and turnaround time requirements

Identify and analyze repetitive issues for root cause determination to ensure feedback is shared with supervisor for communication to appropriate business owners.  The primary contact in communicating issues with business owners would be done by the supervisor or Senior BSR

Acts as a liaison between team members and internal departments on data gathering and problem solving while investigating problems of an unusual nature in their area of responsibility.

Assists with special projects as assigned or directed','!*!Education:  High school diploma or equivalent; Associates degree preferred

Experience:  1 - 3 years previous experience within a call center or customer service environment.

Previous experience in a healthcare environment preferred

Special Skills (e.g. 2nd language):  Spanish helpful not required     

Technical Skills/Requirements: 

Oral and written communication skills sufficient to clearly convey messages to our members

Interpersonal skills required to work well with others

Ability to follow direction and strong attention to detail

Able to be patient and calm when interacting with members

 ','US-FL-Tampa','5519 Idlewild Ave','','Tampa','33601','','','No','No','Billing Resolution Specialist

10 days 3 hours ago



Billing Resolution Specialist Wellcare - Tampa, FL, United States


Location: Tampa, FL

Company Profile:
WellCare Health Plans, Inc. focuses exclusively on providing government-sponsored managed care services, primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, to families, children, seniors and individuals with complex medical needs. The company served approximately 3.8 million members nationwide as of Sept. 30, 2015. For more information about WellCare, please review our website and view the company’s videos. WellCare has developed a full complement of expertise in three major areas of government-sponsored health care…. Medicaid, Medicare Advantage and Medicare Prescription Drug Plans. Leveraging our expertise for our members' benefit is a key part of the value we bring to our members. WellCare focuses on those members who are dually eligible for both Medicaid and Medicare. This is an area of specialization that many other health plans simply do not have. We are committed to continually improving the quality of care and service that we provide to our members. We help our members access the right care at the right time in the appropriate setting. For some members, this includes the use of coordinated care teams and community partnerships. And we’re focused on government customers and use a disciplined approach to ensure a competitive cost structure.